Pregnancy and Gingival Inflammation

Hormonal changes during pregnancy are considered to affect the response of the gingival tissues, with studies suggesting that 36% – 100% of pregnant women suffer pregnancy gingivitis. The aim of this review was to assess the effect of pregnancy on systemically healthy women in terms of gingival inflammation.

The Medline and Embase databases were searched together with the Journalof Periodontology, Journal of Periodontal Research, and Journal of Clinical Periodontology. The references of identified papers were also checked.

Prospective cohort or cross-sectional studies assessing the effect of pregnancy on periodontal health in English were considered. Screening and data abstraction was conducted independently by two reviewers with quality being assessed using the Newcastle-Ottawa scale. The main outcome variable was gingival inflammation, evaluated by gingival index (GI) or bleeding on probing (BOP).

33 studies (14 cohort and 19 cross-sectional) were included.

A significantly lower GI was seen in the first term compared to those in their second or third terms of pregnancy

Lower mean GI scores in postpartum women compared to women in their second or third term of pregnancy

Non-pregnant women had lower mean GI values than women in their second or third term of pregnancy.

The authors concluded:

Despite the limited number of studies included in the meta-analyses, the present systematic review confirms the existence of a significant increase in GI throughout pregnancy and between pregnant versus postpartum or non-pregnant women, without a concomitant increase in plaque levels.

Comment

The authors highlight a number of potential issues with this review that should be taken into consideration. The inclusion of different study designs, the variable periodontal criteria across the studies and the fact that some study data was missing, only presented graphically so they could not be included in the meta-analyses. In addition the authors have only included English language studies so there are likely to be additional relevant studies that could have been included.